 Osteoporosis is a disease in which bones gradually thin, growing fragile and more likely to break. A fracture in the spine, hip, or wrist is often the first sign of the disease. You're more at risk if you're female, Caucasian, or Asian; have certain medical conditions that impair your ability to absorb calcium; or if you have a slender frame or a family history of the disease. Women who've reached menopause are especially vulnerable because they have lower levels of estrogen, a hormone that helps keep bones strong. Men are less likely to develop the disease but more and more cases are reported every year. Although thinning bones can be a natural part of aging, there are things you can do to ward off osteoporosis. Be sure to get the recommended levels of calcium in your diet throughout your life, because it's essential in building strong bones. Daily calcium requirements vary, depending on your age and sex. For women ages 25 to 50, men under 65, and postmenopausal women who take estrogen, daily calcium intake should be 1,000 mg. Pregnant or breastfeeding women need 1,200 to 1,500 mg daily. Postmenopausal women not taking estrogen and men over 65 need 1,500 mg. Calcium-rich foods include dairy products, canned fish with bones, dark green and leafy vegetables, and fortified foods. Your doctor may recommend a calcium supplement if you're not sure you get enough in your diet. To absorb calcium, the body requires vitamin D. Vitamin D is produced in the skin with exposure to sunlight, and is also found in fortified foods. If you're confined indoors or live where there's little sunlight, you may need a daily supplement of 400 IU. Supplements that provide both calcium and vitamin D include >drugstore.com Calcium + D, >Os-Cal Calcium with Vitamin D, >Posture-D, and >Viactiv Soft Calcium Chews plus Vitamin D Supplement for Women. Studies also show that weight bearing exercise--exercise that puts stress on bones, such as running, walking, and tennis--slows down bone loss. To benefit from an exercise program, you must do it regularly. Not smoking and keeping alcohol intake to a minimum also help maintain bone mass. Certain prescription medications help prevent osteoporosis or slow its progress. Estrogen replacement therapy (ERT) slows the dramatic loss of bone mass that can occur after menopause. ERT medications include >Premarin, >Estrace, and >Ogen. Nonhormonal medications such as raloxifene (>Evista), alendronate (>Fosamax), risedronate (>Actonel), and calcitonin (>Miacalcin) slow the breakdown of bone and can benefit women who can't take estrogen because of medical conditions and men. Every woman should discuss her own health and the risks and benefits of ERT with her doctor. Sources:
Applied Therapeutics: The Clinical Use of Drugs. Applied Therapeutics, 1995.
Silverman, H.M., J.A. Romano, G. Glmer. The Vitamin Book: A No-nonsense Consumer Guide. Bantam Books, 1999.
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Orwoll, E. “Alendronate for the Treatment of Osteoporosis in Men,” New England Journal of Medicine 343 (2000).
This answer prepared 1/17/01.
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